Old Age and Survivor's Insurance

PURPOSE: To state an existing policy that actions by the Social
Security Administration (SSA) to suspend benefits to Social Security
beneficiaries in foreign countries for certain specific reasons (stated
below) will not be considered "initial determinations" as described in 20
C.F.R. 404.902, and thus will not be subject to administrative review
process or judicial review as provided for in section 205(g) of the Social
Security Act and 20 CFR 404.900ff. The specific reasons for the suspension
are:

(1) an investigation of the social insurance system of the country of
which the foreign beneficiary is a citizen to determine whether the
requirements of section 202(t)(2) are met is pending; or

(2) the government of a particular country denies requests by SSA for
direct access to beneficiaries in that country to assure their existence,
continuing eligibility and that they receive their benefits.

PERTINENT HISTORY: Initial determinations are determinations on
entitlement to benefits or other similar matters that are subject to
administrative and subsequent judicial review. The types of determinations
that constitute "initial determinations" are discussed in 20 C.F.R.
404.902. An initial determination generally is binding unless a
reconsideration is requested within the stated time period, or unless the
Secretary revises the initial determination (20 C.F.R. 404.905).

With regard to item (1) in the "Purpose" section above --

Section 202(t)(1) of the Social Security Act requires the suspension of
benefits after the sixth consecutive calendar month during all of which a
beneficiary who is not a citizen or a national of the United States is
outside the United States, Section 202(t)(2) provides an exception to
Section 202(t)(1) for citizens of a foreign country which the Secretary
finds has in effect a social insurance or pension system which is of
general application in such country and under which --

(1) periodic benefits or the actuarial equivalent thereof are paid on
account of old age, retirement or death, and

(2) individuals who are citizens of the U.S. but not citizens of such
foreign country and who qualify for such benefits are permitted to receive
such benefits or the actuarial equivalent thereof while outside the
foreign country without regard to the duration of the absence.

The exception to section 202(t)(1) provided by section 202(t)(2) requires
a decision on the part of the Secretary and pending that decision, benefit
payments may be suspended. In addition, the exceptions to paragraph
202(t)(1) provided by subparagraphs 202(t)(4)(A) and 202(t)(4)(B) also
require a determination under paragraph 202(t)(2). Pending an
investigation to determine whether the exception in Section 202(t)(2) may
apply, the nonpayment provision in Section 202(t)(1) is applicable and,
therefore, benefits to the affected beneficiaries may need to be
suspended. Similar pending investigations that result in the suspension of
benefits are specified in 20 C.F.R. 404.903 as administrative actions that
are not initial determinations.

With regard to item (2) in the "Purpose" section above --

Section 205(a) of the Social Security Act reads as follows:

The Secretary shall have full power and authority to make rules and
regulations and to establish procedures, not inconsistent with the
provisions of this title, which are necessary or appropriate to carry out
such provisions, and shall adopt reasonable and proper rules and
regulations to regulate and provide for the nature and extent of the
proofs and evidence and the method of taking and furnishing the same in
order to establish the right to benefits hereunder.

That authority is the basis for the procedures under which SSA continues
to pay benefits only when there is reasonable assurance concerning the
integrity of the payments; i.e., the beneficiary is alive, eligibility
requirements continue to be met and the beneficiary is able to receive and
use the benefits.

Where a foreign country denies SSA access to beneficiaries, there is no
sound basis for ensuring the integrity of payments. Since these
suspensions are made pending investigations which must be deferred until
the foreign government permits access to beneficiaries in that country,
they are not initial determinations subject to review but rather are the
type of action described in 202 C.F.R. 404.903.

POLICY INTERPRETATION:

1. Suspending benefits pending an investigation and determination as to
whether a country meets the criteria of Section 202(t)(2) of the Social
Security Act is not an initial determination.

2. Suspending benefits pending agreement by a country to allow direct
access to Social Security beneficiaries to ensure the integrity of benefit
payments is not an initial determination.

As administrative actions that are not initial determinations, the
actions noted above may e reviewed by the Secretary, but they are not
subject to the administrative review process or judicial review as
provided for in 20 C.F.R. 404.900ff.

FURTHER INFORMATION: 20 C.F.R. 404.902,which lists actions that are
initial determinations, and 20 C.F.R. 404.903, which lists actions that
are not initial determinations, provide that the actions listed are not
all-inclusive. This ruling sets forth the established policy regarding two
actions which are not initial determinations but which are not specified
in 20 C.F.F. 404.903, and thereby clarifies the nature of these
actions.

EFFECTIVE DATE:

SSA policy for nonpayment of benefits pending an investigation and
determination of Section 202(t)(2) status has been in effect since 1957
when foreign countries first had to meet the criteria in Section 202(t)(2)
of the Social Security Act as an exception to Section 202(t)(1).

The policy regarding suspension of benefits in a foreign country based on
non-access to beneficiaries has been in effect since December 1968, when
the U.S. Department of the Treasury removed the restrictions on sending
checks to the U.S.S.R., and the U.S.S.R. refused access to beneficiaries
in that country.

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